Journal of the American Academy of Child & Adolescent Psychiatry
SPECIAL COMMUNICATIONSchool Refusal and Psychiatric Disorders: A Community Study
Section snippets
Sample
The Great Smoky Mountains Study (GSMS) is an ongoing, longitudinal study of the development of psychiatric disorders in youths living in North Carolina. Full details of the study design can be found elsewhere (Costello et al., 1996).
Briefly, a representative sample of 4,500 children aged 9, 11, and 13 years, recruited through the Student Information Management System of the public school systems of 11 counties in western North Carolina, was selected using a household equal probability design. A
Prevalence
The 3-month prevalence of overall anxious school refusal was 2.0% (n = 165) and of truancy was 6.2% (n = 517). Anxious school refusers were 6.8 times more likely than children without anxious school refusal to be truant (OR = 6.8, 95% CI 3.1, 15; p < .0001). A quarter of anxious school refusers and 8.1% of truants were mixed school refusers (0.5% prevalence; n = 35). Table 1 describes the prevalence, gender, and age characteristics and frequency of the three subtypes of school refusal.
Psychopathology
Table 2
DISCUSSION
The prevalence, age, and gender characteristics of anxious school refusal and truancy were consistent with previous studies (Granell de Aldaz et al., 1984; King and Bernstein, 2001; Stickney and Miltenberger, 1998). Use of “agnostic” definitions of school refusal based on descriptions of the behavior rather than assumptions about etiology or associated psychopathology led to three main findings: (1) All three types of school refusal were significantly associated with psychiatric disorders. (2)
REFERENCES (52)
- et al.
The Child and Adolescent Psychiatric Assessment (CAPA)
J Am Acad Child Adolesc Psychiatry
(2000) Comorbidity and severity of anxiety and depressive disorders in a clinic sample
J Am Acad Child Adolesc Psychiatry
(1991)- et al.
School refusal: family constellation and family functioning
J Anxiety Disord
(1996) - et al.
School phobia: the overlap of affective and anxiety disorders
J Am Acad Child Psychiatry
(1986) - et al.
Somatic symptoms in anxious-depressed school refusers
J Am Acad Child Adolesc Psychiatry
(1997) - et al.
School phobia: patterns of family functioning
J Am Acad Child Adolesc Psychiatry
(1990) - et al.
Family dimensions in anxious-depressed school refusers
J Anxiety Disord
(1999) - et al.
School refusal in children and adolescents: a review of the past 10 years
J Am Acad Child Adolesc Psychiatry
(2001) - et al.
Cognitive-behavioral treatment of school-refusing children: a controlled evaluation
J Am Acad Child Adolesc Psychiatry
(1998) - et al.
Cognitive-behavioral treatment of school phobia
J Am Acad Child Adolesc Psychiatry
(1998)
School refusal in anxiety-disordered children and adolescents
J Am Acad Child Adolesc Psychiatry
The relationship of school phobia to childhood depression
J Psychiatry
Diagnostic and Statistical Manual of Mental Disorders
A test-retest reliability study of child-reported psychiatric symptoms and diagnoses using the Child and Adolescent Psychiatric Assessment (CAPA-C)
Psychol Med
Comorbidity
J Child Psychol Psychiatry
Precision, reliability and accuracy in the dating of symptom onsets in child and adolescent psychopathology
J Child Psychol Psychiatry
The Child and Adolescent Psychiatric Assessment (CAPA)
Psychol Med
Absence from school and mental health
Br J Psychiatry
DSM-III-R Disorders, social factors and management of school attendance problems in the normal population
J Child Psychol Psychiatry
School phobia: its classification and relationship to dependency
J Child Psychol Psychiatry
The behavioural treatment of school refusal: a comparative study
Behav Res Ther
The identification of psychiatric disorders in children who fail to attend school: a cluster analysis of a nonclinical population
Psychol Med
A contribution to the study of truancy
Am J Orthopsychiatry
School refusal
Educ Res
A model of persistent absenteeism
Educ Res
The Great Smoky Mountains Study of Youth: goals, designs, methods, and the prevalence of DSM-III-R disorders
Arch Gen Psychiatry
Cited by (379)
Staying connected: An umbrella review of meta-analyses on the push-and-pull of social connection in depression
2024, Journal of Affective DisordersTesting the structure of the BERRI using exploratory and confirmatory factor analysis
2024, Children and Youth Services ReviewAnxiety level and school refusal in anxiety disorders in teenagers
2023, Neuropsychiatrie de l'Enfance et de l'AdolescenceSleep and dropout from upper secondary school: A register-linked study
2023, Sleep HealthContribution of care study in adolescents in anxious school refusal with addiction to video games through a clinical illustration
2023, Neuropsychiatrie de l'Enfance et de l'Adolescence
This project was supported by NIMH grants MH-02016 and MH-48085. Dr. Egger receives support from an NIMH Career Development Award (5K23-MH-02016) and a NARSAD Young Investigator Award. The authors acknowledge the assistance of Jane Duncan in the preparation of this paper.